Acne is not just a teenage rite of passage, but according to research summarized in a recent Dermatology Times article, adult acne has increased by about 10% worldwide in the last ten years. This may indicate a meaningful shift in when and where acne develops. According to Dr. EB Henebeng of U.S. Dermatology Partners Fairfax, “Many people think of acne as something that only affects teenagers, but acne can develop at any age. While acne remains very common among adolescents and young adults, we are seeing more patients in their 30s, 40s, and beyond experiencing persistent or new-onset acne. In many cases, adult acne can be more inflammatory, more resistant to treatment, and have a greater impact on overall skin health and confidence. The good news is that there are effective treatment options available to help manage symptoms and improve the skin.” In this blog, Dr. EB dives into underlying causes and adult acne treatment and management tips.
Why Is Adult Acne on the Rise?
Understanding why adult acne is on the rise starts with learning what causes adult acne. Dr. EB says, “Adult acne is a complex condition, and there’s rarely one single factor responsible for breakouts. In many cases, several internal and external factors work together to trigger acne and influence how severe or persistent it becomes. That’s why identifying the underlying causes is such an important part of creating an effective treatment plan.” Some of the main causes of adult acne include:
- Hormonal fluctuations – this is the main driver of acne for patients of all ages. Changing hormone levels trigger oil production, which increases risk for clogged pores and acne breakouts. Hormonal triggers include menstrual cycles, pregnancy, perimenopause, and androgen sensitivity. Hormonal acne breakouts are most common along the lower face, predominantly on the jaw and chin.
- Lifestyle factors – numerous lifestyle factors impact adult acne development, including cortisol-triggering stress that leads to oil production and inflammation, sleep disruption that hinders cellular repair, and inconsistent skincare.
- Dietary factors – diet on its own doesn’t cause acne, but certain foods can increase risk for breakouts. Specifically, high-glycemic foods that are high in sugar and carbohydrates can spike insulin levels, which increases oil production and inflammation. For others, sensitivity to certain hormones in dairy products and meats can trigger increased oil production.
- Environmental factors – exposure to pollution, toxins, and environmental aggressors can all weaken the skin barrier. This damage to the skin’s protective barrier increases risk for adult acne, and it can worsen acne and make it harder to heal following a breakout.
- Skincare and cosmetics – using the wrong skincare products and certain types of makeup can worsen acne breakouts. Thick, heavy skincare products and cosmetics can trap oil and bacteria in pores. Products that are too harsh can dry or irritate skin, leading to increased inflammation and redness.
- Genetics – having one or more relatives who experienced adult acne increases risk since genetics influence hormone levels, inflammatory response, skin cell turnover, and oil production all of which contribute to breakouts.
How Adult Acne Differs from Teen Acne
Compared with acne that develops in teens, hormonal acne in adults can be very different. Adult acne has unique characteristics and requires a targeted treatment and management approach. Some of the ways that adult acne differs from breakouts in teen years include:
- More inflammatory blemishes – adult acne tends to develop deeper in the skin, leading to painful and inflamed cystic and nodular acne, while teen acne tends to be mostly surface-level pimples.
- Breakout locations – teenage acne tends to be focused in the “T-zone” covering the forehead, nose, and chin. Adult acne is typically on the lower half of the face and neck.
- Less oil and more skin sensitivity – while supple teen skin tends to be oily, leading to acne breakouts, adult skin affected by acne is prone to dryness and irritation. That means harsh chemicals used to treat teens are no longer the right options. Instead, soothing formulas should be used.
- Increased risk for scarring – scar tissue development and hyperpigmentation are both common, leaving skin with dark spots and uneven texture, especially when the right treatment plan isn’t maintained.
Common Types of Adult Acne
Not all adult acne is the same. Adults experience a range of acne types, including:
- Hormonal acne – this is the most common form of adult acne. Breakouts typically occur along the jaw and chin. Common among women, this form of acne leads to deep lesions, and often occurs cyclically in women.
- Deep, inflammatory acne – composed of red, swollen papules and pus-filled lesions called pustules. These forms of acne are often painful and difficult to treat.
- Cystic acne – this painful form of acne leads to nodules beneath the skin, infection, and inflammation. Finding the right cystic acne treatment is essential to minimize scarring.
- Comedonal acne – blackheads and whiteheads are the more traditional form of an acne breakout. It’s less common in adults, but it’s not impossible.
Following any of the above breakouts, adults can develop post-inflammatory hyperpigmentation. This is when dark spots persist even after the skin has fully healed, leaving patients with an uneven skin tone.
Best Products for Adult Acne
When it comes to creating a skincare routine to manage adult acne, Dr. EB Henebeng says, “No two patients need exactly the same products for adult acne or the same skincare routine. Instead, it’s important to find the right products for the individual’s needs. Once an effective skincare plan is developed, the patient should follow it consistently even if they feel like it’s not working as quickly as they’d like. It can take months for at-home care to deliver the desired acne treatment results.” When choosing skincare products for adult acne, look for options that manage acne without over-drying or irritating skin. Some important products and ingredients to include in your daily routine are outlined below:
- Gentle cleanser – look for a cleanser formulated for sensitive or acne-prone skin. Specifically, products that are non-comedogenic (formulated to avoid clogging pores) and sulfate-free. Use cleansers twice a day (morning and evening) and any time your skin is very sweaty or dirty. Don’t over cleanse. This can strip too much moisture and trigger additional oil production, which can clog pores.
- Retinols – over-the-counter products with retinols are designed to increase cell turnover. This reduces risks for clogged pores, blemishes, and breakouts. Additionally, the accelerated skin cell turnover also reduces the appearance of fine lines.
- Salicylic acid – it is a form of beta hydroxy acid (BHA) that penetrates into pores to dissolve oil, dead skin cells, bacteria, and other grime. These products are great to prevent breakouts and clear up blemishes, especially for those with oily skin.
- Benzoyl peroxide – for those with inflamed acne breakouts, benzoyl peroxide products target acne-causing bacteria that lead to breakouts. Start with lower concentrations to avoid over-drying.
- Niacinamide – this is a multi-beneficial skincare ingredient for acne-prone skin. It reduces redness, decreases inflammation, regulates oil production, and strengthens the skin’s protective barrier.
- Moisturizer – oily and acne-prone skin doesn’t mean you don’t need moisturizer. Failing to hydrate skin can trigger over-production of skin’s natural oils that increases oiliness and greasiness, leading to increased risk for breakouts. Look for oil-free moisturizers.
- Sunscreen – applying sunscreen is essential for everyone, but for those with acne-prone skin, sunscreen is even more important. It protects from UV damage and reduces risk for hyperpigmentation. Look for a sunblock that is broad-spectrum and formulated for acne-prone skin.
Professional Acne Treatment Options
For those in need of more advanced adult acne treatment options, Dr. EB Henebeng says, “Many cases of adult acne can improve with consistent skincare and over-the-counter products, but persistent or more severe breakouts often require a professional treatment approach. If acne is painful, causing scarring, or not responding to at-home care, a dermatologist can help identify the underlying causes and recommend targeted treatment options to improve both acne and overall skin health.” Below, Dr. EB breaks down some of the most recommended professional treatment options for adult acne:
- Prescription topicals – retinoids (the prescription-strength version of retinols) may be prescribed to further increase skin cell turnover and prevent clogged pores while reducing risk for scarring and hyperpigmentation. Additionally, topical antibiotics may be used to reduce inflammation and kill bacteria, accelerating healing.
- Oral medications – for women, hormonal therapy, is often recommended for adult acne. Birth control pills and anti-androgens may be used on their own or combined to reduce oil production and regulate hormones. Oral antibiotics may be used by men and women to reduce inflammation and bacterial colonization that worsens acne. Finally, isotretinoin (Accutane) may be prescribed for the most severe cases. This medication has side effects, but the long-term skin clearance may be worth a few months managing the adverse effects.
- Chemical peels – a professional chemical peel procedure is performed in the dermatologist’s office. It removes outer layers of skin and unclogs pores. This generally leads to shorter breakouts with less discomfort. Chemical peels also reduce risk for hyperpigmentation and improve skin tone and texture.
- Laser therapies – those with inflammatory adult acne may want to consider laser and light therapy options. These targeted treatments can be used to improve several acne side effects, including diminishing inflammation and redness, reducing acne-causing bacteria, and improving skin tone and texture. For persistent acne breakouts, laser therapy accelerates healing and can improve chances for long-term clearance.
- Microneedling – this treatment works by triggering the natural healing process. A unique handheld tool is used to create numerous microscopic injuries in the affected area. As the healing process begins, skin becomes smoother and collagen production increases. Following microneedling, topical skincare products are also more fully absorbed, improving efficacy. This procedure is most often recommended to address hyperpigmentation, scarring, and skin redness and texture changes after an acne breakout.
When to See a Dermatologist
If you’re struggling with persistent acne in your 30s and 40s, it may be time to contact your dermatologist, especially if you notice any of the following:
- Over-the-counter skincare products aren’t working.
- Persistent or worsening acne breakouts.
- Deep, painful acne.
- You notice scarring or hyperpigmentation after breakouts.
- Acne impacts your quality of life or self-worth.
Learn About Treatment Options for Adult Acne Breakouts
As a final thought, Dr. EB Henebeng adds, “Adult acne can be frustrating, but effective treatment starts with understanding that every patient’s skin and triggers are different. With a personalized treatment plan that may include skincare, lifestyle changes, and professional therapies, many patients can successfully manage breakouts and improve their skin health.”
Schedule an Acne Treatment Consultation
If you are just developing acne for the first time as an adult or you’ve struggled to manage acne symptoms since your teens, it’s time to talk with a professional about your options. Working with the U.S. Dermatology Partners team is simple. Take just a few moments to fill out our scheduling request form online. Once we hear from you, a local office will reach out to finalize the details.
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